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German Congress of Orthopaedics and Traumatology (DKOU 2019)

22. - 25.10.2019, Berlin

No Growth Disturbance After Trochleoplasty for Recurrent Patellar Dislocation in Adolescents With Open Growth Plates

Meeting Abstract

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  • presenting/speaker Manfred Nelitz - MVZ Oberstdorf, Lehrkrankenhaus der Universität Ulm, Oberstdorf, Germany
  • Sean Robert Williams - Kliniken Kempten-Oberallgäu, Akademische Lehrkrankenhäuser der Universität Ulm, Oberstdorf, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2019). Berlin, 22.-25.10.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocAB75-132

doi: 10.3205/19dkou681, urn:nbn:de:0183-19dkou6812

Published: October 22, 2019

© 2019 Nelitz et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objectives: Trochlear dysplasia is the most important risk factor for patellofemoral instability among adolescents; therefore, trochleoplasty to reshape the trochlear groove is the treatment of choice for patients with high-grade trochlear dysplasia. However, in the presence of open growth plates, there is a potential risk of injury to the distal femoral growth plate and subsequent growth disturbance. As such, most authors do not recommend trochleoplasty for skeletally immature patients. The effect of trochleoplasty on femoral growth when performed before closure of the distal femoral physis remains unclear.

For patients with open growth plates and an expected growth < 2 years, trochleoplasty does not cause growth disturbance of the distal femur.

Methods: Eighteen consecutive adolescents (18 knees) with open physes and severe trochlear dysplasia underwent thin flap trochleoplasty. Pre- and postoperative radiographic examination included anteroposterior and lateral views to assess leg axis and patella alta. A preoperative radiograph of the left hand was performed to measure skeletal age. Magnetic resonance imaging was performed to evaluate trochlear dysplasia and tibial tubercle-trochlear groove distance. Evaluation included pre- and postoperative physical examination with evaluation of leg length and leg axis, Kujala score, and Tegner activity score.

Results and conclusion: In this study, trochleoplasty as a treatment for patellofemoral instability of patients with open physes and an expected growth of not more than 2 years showed good clinical results without redislocation and with no growth disturbance. Therefore, for selected adolescent patients with high-grade trochlear dysplasia, trochleoplasty can be safely performed up to 2 years before the projected end of growth.